Laura Martin, MD, Associate Medical Director, CPHP

We’ve all seen it, most of us have felt it, and a few of us have conquered it without changing jobs or taking a break from our medical careers: burnout. Over the last two decades, we’ve come to better understand the prevalence and sequelae of burnout. We’ve felt burned out by burnout presentations that come without solutions. We’ve felt betrayed by well-meaning workplace interventions that offer yoga (that we may not like) with our co-workers (who we may not want to downward dog next to) and that only delay completing our work tasks for the day. Universal interventions such as yoga can help improve strength, flexibility, spirituality, burnout, and emotional wellness for some people; they are not for everyone. Burnout is a syndrome of exhaustion, depersonalization, and inefficacy that arises from a unique mixture of factors in an individual’s personal life, workplace culture, and workflow. Therefore, solutions for individuals must be tailored to their lived experiences. Because workplace culture and workflow-based changes move slowly, if at all, physicians must seek effective strategies to reduce burnout rather than wait. Luckily, there is an intervention for burnout that has shown efficacy in at least nine randomized controlled trials (RCTs) over the last seven years: physician coaching. 

Many physicians don’t know how a coach can help. The National Board of Health and Wellness Coaches (a partner of the National Board of Medical Examiners) states, “coaches assist clients to use their own insight, personal strengths, and resources to set goals, commit to action steps, and establish accountability in building an envisioned healthy lifestyle.”  Physician coaching creates a holding space of active listening, inquiry, autonomy building, positive regard, and compassion that allows each physician to create and meet personalized goals that are more effective for their particular, and at times singular, situations at home and work. Examples of interventions could include, but are not limited to, figuring out a work-flow template that results in all work being completed by the end of the shift, using self-compassion to silence your inner critic or be more patient with your children at night, taking the time to consider your strengths and values to decide what you want to do (versus someone else dictating your schedule), developing awareness practices to reduce the likelihood of losing your temper and taking it out on others while on call, picking up old hobbies or friendships again, or increasing cardiovascular exercise to improve overall health and energy during the work day.  

The nine coaching RCTs showed that effective coaching for physician burnout can be delivered in multiple formats, including in person or online; individually or in small groups; within or outside the workplace; synchronously or asynchronously; and by physicians or non-physicians. Significant improvements occur with as little as four hours of coaching spread over several months and gains are sustained for at least six months later. Improvements have been noted for emotional exhaustion, burnout, resilience, quality of life, work engagement, psychological capital, job satisfaction, imposter syndrome, moral injury, self-compassion, flourishing, disengagement, professional fulfillment, coping skills, and gratitude. Unfortunately, waiting for burnout to improve on its own often led to no change in symptoms or worsening symptoms. Please don’t let that happen. Your patients, your community and you need you. Remember, coaching is not a substitute for therapy. Please seek out a therapist or psychiatrist if your symptoms are due to an illness such as depression. Many individuals benefit from working with both a coach and a mental health treatment provider.

I encourage you to periodically check in with yourself using a screener such as the Stanford Professional Fulfillment Index (med.stanford.edu/wellmd/selfassessment.html) or the Mayo Wellbeing Index (mywellbeingindex.org), as we often don’t appreciate when we are starting to feel burned out or misjudge how burned out we are. And it’s a great way to track your progress, whatever you are doing to improve. Take a moment to check in with your workplace to see what burnout and coaching resources they offer. Often there is CME or other leadership development money available if coaching isn’t offered in-house. If they don’t have any resources, consider approaching your specialty organizations. And certainly feel free to give the Colorado Physician Health Program (CPHP) a call at 720-810-9131. We have Doc2Doc Wellbeing Consulting and other resources to support you!